Sensibility Loss after ACL Reconstruction with Hamstring Graft

Abstract

Injury to the infrapatellar branch of the saphenous nerve (IPBSN), is known to cause regional hypoesthesia of the lower leg after anterior cruciate ligament (ACL) reconstruction. The aim of this study was to determine if the orientation of the graft harvest incision does influence the prevalence of postoperative hypoesthesia. Furthermore, to describe change, if any, of the hypoesthetic area, during the first postoperative year. Our hypothesis was that an oblique incision parallel to the nerve branch would reduce the incidence of this complication and the area with hypoesthesia after ACL reconstruction, compared to the vertical incision. Secondly, that the area with hypoesthesia is reduced over time. Fifty patients underwent a primary ACL reconstruction using hamstring graft. Twenty-five patients were operated using a vertical incision for graft harvest, and 25 were operated using a slightly oblique incision. Twelve days after surgery and at a one year follow-up the patients had their sensibility of the lower leg examined. We found that hypoesthesia is a common complication (88 %) after hamstring ACL surgery. Change from vertical to slightly oblique incision did not reduce the morbidity. Furthermore, the area with sensory loss, felt by the patient shortly after surgery, was shown to decrease significantly by 46.3 percent after one year.

Key words

complication - hamstring graft - hypoesthesia - saphenous nerve - infrapatellar branch

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